摘要
For a long time, a combination of interferon and ribavirin has been used to treat viral hepatitis C, but the sustained virological response was only achieved in 45% of cases and side effects were serious [1]. Direct acting antivirals (DAA) have provided a cure for almost everyone with hepatitis C, with few side effects. The Purpose of Our Work is to compare the results of treatment for viral hepatitis C before and after DAA. Patients and Methods: This is a retrospective study, bringing together all patients with chronic viral hepatitis C treated between January 2009 and March 2020 at the University Hospital Hassan II in Fez, Morocco. The epidemiological, clinical, biological, virological characteristics of the included patients were collected from the two groups: A, treated with interferon and ribavirin or by triple therapy and B, treated with DAA. Results: 162 patients were included, the average age was 55 y/o, with 90 women and 72 men. 88 patients (54.3%) were already cirrhotic, of which 61 were compensated and 27 were decompensated. Genotype 1 was dominant with a frequency of 71.6%, 107 patients (66%) initially treated with old HCV treatments and 55 (34%) treated with DAA. Sustained viral response was obtained in 59 cases (55.14%) in group A versus 54 cases (98.18%) in group B with a very significant difference (p < 0.0001). Treatment failure was observed in 14 patients (13.1%) in group A and only one patient, i.e. 2% in group B (p = 0.019). 14 patients relapsed in group A (13.1%) versus 0 patient in group B (p = 0.003). The tolerance of the treatment was excellent in group B as a whole with only five patients (9%) reported side effects which were minor, not leading to the discontinuation of treatment while the side effects were major in 49 patients (45.7%) in group A with led to the permanent discontinuation of treatment in 6 patients. The difference in side effects between the two groups was very significant with (p Conclusion: Our study has shown the superiority of DAA in terms of efficacy and tolerance compared to the old treatments for chronic hepatitis C. In addition, these treatments allow almost systematic viral elimination and therefore consequently a reduction in the risk of complications hepatic with a short time of treatment.
For a long time, a combination of interferon and ribavirin has been used to treat viral hepatitis C, but the sustained virological response was only achieved in 45% of cases and side effects were serious [1]. Direct acting antivirals (DAA) have provided a cure for almost everyone with hepatitis C, with few side effects. The Purpose of Our Work is to compare the results of treatment for viral hepatitis C before and after DAA. Patients and Methods: This is a retrospective study, bringing together all patients with chronic viral hepatitis C treated between January 2009 and March 2020 at the University Hospital Hassan II in Fez, Morocco. The epidemiological, clinical, biological, virological characteristics of the included patients were collected from the two groups: A, treated with interferon and ribavirin or by triple therapy and B, treated with DAA. Results: 162 patients were included, the average age was 55 y/o, with 90 women and 72 men. 88 patients (54.3%) were already cirrhotic, of which 61 were compensated and 27 were decompensated. Genotype 1 was dominant with a frequency of 71.6%, 107 patients (66%) initially treated with old HCV treatments and 55 (34%) treated with DAA. Sustained viral response was obtained in 59 cases (55.14%) in group A versus 54 cases (98.18%) in group B with a very significant difference (p < 0.0001). Treatment failure was observed in 14 patients (13.1%) in group A and only one patient, i.e. 2% in group B (p = 0.019). 14 patients relapsed in group A (13.1%) versus 0 patient in group B (p = 0.003). The tolerance of the treatment was excellent in group B as a whole with only five patients (9%) reported side effects which were minor, not leading to the discontinuation of treatment while the side effects were major in 49 patients (45.7%) in group A with led to the permanent discontinuation of treatment in 6 patients. The difference in side effects between the two groups was very significant with (p Conclusion: Our study has shown the superiority of DAA in terms of efficacy and tolerance compared to the old treatments for chronic hepatitis C. In addition, these treatments allow almost systematic viral elimination and therefore consequently a reduction in the risk of complications hepatic with a short time of treatment.
作者
Hakima Abid
Maryam Khayari
Hajar Cherkaoui
Maria Lahlali
Nada Lahmidani
Mounia Elyousfi
Nourdin Aqodad
Sidi Adil Ibrahimi
Mohamed El Abkari
Hakima Abid;Maryam Khayari;Hajar Cherkaoui;Maria Lahlali;Nada Lahmidani;Mounia Elyousfi;Nourdin Aqodad;Sidi Adil Ibrahimi;Mohamed El Abkari(Hepato-Gastroenterology Unit, University Hospital Hassan II, Fez, Morocco;Laboratory of Human Pathology, Biomedicine and Environment, Fez, Morocco;Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, Morocco;Hepato-Gastroenterology Unit, University Hospital Ibn Zohr, Agadir, Morocco)
